Eating Disorders and Alcoholism

Both conditions are treatable, and should be treated at the same time.

The simple answer, yes. However, there is a lot more to it than that. Both eating disorders and alcohol abuse are considered to be forms of self-harm, and both can be very dangerous.

The 3 most common types of eating disorders that we will focus on are anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia Nervosa is best described as refusing to keep healthy body weight in fear of becoming ‘fat’. Patients with anorexia commonly restrict the types of food and amount of calories they eat. This leads to extreme malnutrition and very unhealthy body weights for age and height. There are two types of anorexia nervosa:

• Restricting type and binge.
• purging type.

Restricting type is when someone follows extreme, strict dieting, often not eating at all. Binge and/or purging type is when someone binges (eating large amounts of food in a small period of time and a sense of lack of control while eating), and/or they purge where they force themselves to vomit following a binge, or overuse diuretics (laxatives, water pills, etc.).

People with anorexia nervosa have a very distorted idea of what they look like, and view themselves as overweight, even when they are extremely underweight. They also have difficulty seeing their health and low weight as a problem.

Some signs and symptoms of anorexia nervosa are: 

• Dramatic weight loss
• Obsession with weight, food, calories, fat grams, and dieting
• Dizziness, light-headedness
• A lot of comments about being “fat” or overweight despite being thin
• The intense need for control
• Constant excuses to avoid eating with others, or to avoid other situations involving food
• Fainting
• Withdrawing from usual friends and activities
• Isolating themselves and keeping secrets

People who suffer from both anorexia nervosa and alcohol disorder often use alcohol as a way to suppress their appetites. Alcohol use is not as common for those with anorexia as it is for those with bulimia or binge eating, but can be very dangerous.

This is particularly due to the risks of drinking alcohol on an empty stomach. This increases memory loss, alcohol poisoning, and other alcohol-related injuries.

Bulimia Nervosa is an eating disorder where someone has episodes that occur frequently of binge eating followed by purging to reverse the binging. People suffering from bulimia consume large amounts of food, then try to get rid of the weight gain or the food by throwing up, fasting, taking laxatives, fasting, or exercising more than normal.

People who have been diagnosed with bulimia nervosa use very extreme methods to control their weight and overcompensate for binge eating.

These methods include vomiting, intense dieting or fasting, intense exercise, abusing laxatives, diet pills, or diuretics.

When someone has bulimia nervosa, it is not uncommon for them to also abuse alcohol. Alcohol, together with other drug (AOD)-use conditions are especially common in women suffering from bulimia nervosa. A lot of bulimics who drink consume alcohol to vomit, according to eating disorder experts, because liquid, like alcohol, is easier to purge.

This is especially dangerous due to the high amounts of alcohol consumed in a small period of time. Teenagers and younger adults are at high risk for suicide, unprotected sex, theft, and other high-risk behaviors due to alcohol abuse.

Binge Eating Disorder is when someone cycles through episodes of binge eating, without overcompensating the way bulimics do, as mentioned above. People with binge eating feel a lack of control while they eat, and often experience intense guilt and shame afterward.

People suffering from binge eating disorders have a very high risk for health conditions such as obesity and complications that go along with it.

People who suffer from binge eating disorder often binge on alcohol as well, much like people with bulimia. The difference is they do not purge like those with bulimia do.

They also are likely to consume higher amounts of alcohol to be able to ‘feel it’ due to their higher weight which leads to increased risk for alcohol-related complications such as cirrhosis and other liver disorders.

‘Drunkorexia‘ is a recent slang term that has become popular to describe certain people who eat fewer calories to drink more, often in college. People who count calories, particularly women, do so to maintain a certain weight or reach a certain weight.

This is something that happens when people start strict diets and have certain calorie goals. If someone wants to go out for a drink, someone who is considered to be a ‘drunkorexic’ will eat less during the day so she/he can consume more alcohol while staying in their calorie limit.

One of the biggest problems with this is that alcohol has no nutritional value. This easily leads to malnourishment on top of the other health and social risks that are often thought of concerning alcoholism.

As previously stated, this is most common among college-aged females. However, this does affect both men and women and can happen at any age. It is thought that this happens for college girls the most due to peer pressure to ‘party’ as well as to avoid the common ‘freshman 15′.

This can be easily overlooked at first since there is usually no immediate weight loss, but if continued can become a very serious problem.

When someone enters treatment for eating disorders, they immediately begin to work on behaviors related to food, eating, and exercise. This can cause alcohol problems to increase. The increase of alcohol use can cause problems for the treatment, leading to a referral for alcohol use treatment too.

This slows overall recovery, and can create a cycle of being well, then unwell, and so on. This is why it is very important to seek treatment for both disorders together in an integrated program. These programs use evidence-based therapies and other means, such as:

• • Motivational Enhancement Therapy (MET) which focuses on the motivation for change
  • Dialectical Behavior Therapy (DBT) which focuses on regulating emotions and distress tolerance
  • Acceptance and Commitment Therapy (ACT) which focuses on exposure treatment and commitment to action
  • Cognitive Behavioral Therapy (CBT) which is focused on relapse prevention
  • Cognitive Remediation Therapy (CRT) focusing on the big picture

You may also reach out to a treatment facility to help you recover from alcohol abuse and help set you on the path to recovery.

The National Eating Disorder Association provides a website with access to live chat, a text line if you text ‘NEDA’ to 741741, and a hotline number 1-800-931-2237